Appendix 2

GREYS EDUCATION CENTRE –HOSPITAL EDUCATION (OUTREACH)

REQUEST FOR MEDICAL INFORMATION TO SUPPORT INVOLVEMENT

Please use guidelines overleaf. If guidance is not printed on the reverse please telephone: 01234 408456

The Local Authority (LA) expects that all children and young people attend school and thereby have access to the full curriculum or as much as their medical condition will allow. The aim of the Hospital Education Outreach Team is to maintain these pupils within their mainstream school wherever possible. Each school now has a Named Contact for dealing with pupils who are unable to attend school because of medical needs. For those pupils who are unable to attend school for a period of time through illness, the Support Team will plan a reintegration programme with the family and school, to support the pupil back into full time mainstream education at the earliest opportunity.

A request to the Hospital Education Outreach Team should only be made in exceptional circumstances and not as an alternative means of education.

1. To be completed by the School’s Named Contact for Pupils with Medical Needs:
Name of Pupil: / Date of Birth: / Year Group:
Pupil Address:
School Name: / School Telephone No:
Last date pupil attended school regularly:
2. To be completed by Family:
Name of pupil’s GP:
GP Address:
I give my consent for this form to be completed by the appropriate Medical professional.
I give my consent for information to be shared between Health and Educational professionals.
Signature: Pupil (in Year 7 or above)
Signature: / Parent/Carer (please delete)
Print Name (Parent/Carer): / Date:

3. To be completed by Paediatrician/Child Psychiatrist (if being completed by a G.P., please see guidance)

Consultant and other medical professionals involved or referrals made (if appropriate):
Hospital (if appropriate):
Medical reasons why the pupil is not fit enough to attend full time education at his/her school:
Is the pupil fit enough to attend part time education at his/her school?
Any other relevant information (see reverse of sheet for guidance):
Date of next medical review:
Name and Title:
Signature: / Date:

Data Protection Act 1988 – All information will be held on file and/or computerised by Greys Education Centre for the purpose of providing education support. All information will be safeguarded and will not be divulged to any otherindividual(s) or organisation(s), or for any other purposes.

This referral will be shared by all contributors to the form and passed to a Panel for consideration.

Guidance Notes (please enter details for all sections of this form)

Section 1 - School:

Last date pupil attended school – please state the last date when the pupil attended school regularly/part of a planned reintegration programme

Section 2 – Parent/Carer:

This form must be completed by the Parent/Carer before being passed to the appropriate Medical professional. If the pupil is aged over 11, s/he should also sign consent.

  • If your child has not seen the doctor within the last 3 weeks you will need to make an appointment for your child to see the doctor and take this form with you.

Section 3 – GP/Paediatrician/Child Psychiatrist:

  • A General Practitioner may complete this form in order to ensure support is arranged without delay. On-going medical advice should be from the patient’s paediatrician/psychiatrist.
  • Could the pupil attend part time education at his/her school? Support programmes of education are individual and flexible for each pupil, eg some support teaching can be provided at an alternative venue with the pupil accessing some lessons in school/going into school occasionally in the week to maintain peer contact.
  • Any other relevant guidance. Please make any comments and give any background information which you feel is important in this section.

-if pupil can attend school part time please suggest number of hours per day eg 1 hour per day/mornings only

-any issues relating to staff safety eg infectious diseases

-prescribed medication and any side effects

Ongoing Liaison

-The education of pupils with medical needs is a partnership. It is essential that education, health and other agencies work closely together to enable a pupil with medical needs to receive appropriate education. Meetings are held with the pupils’ family, school and Support Team half termly – your attendance at these meetings is always welcomed. Unfortunately, there is no funding for this. Meeting can be held in Bedford Hospital or your Practice if this would help.

-Notes of meetings relating to the pupil during their time of illness will be copied to you.

-Updated medical advice is usually requested termly.

-Please contact the Head of Medical Needsshould you wish to discuss any issues further.

-There are regular meetings between Greys Education Centre, the CCG, CAMHS and CHUMS to discuss how we work together. Issues can be discussed at this meeting by contacting the Head of Hospital Education.

Contact details:
Paul Devereux, Head of Hospital Education
Greys Education Centre, Chestnut Avenue, Bromham, Bedford MK43 8HP
Tel No: 01234 408456
Fax No: 01234 889324
Email:
Further enquiries or concerns: contact Terry Ashmore, Executive Headteacher, of BILTT at the above address.
Tel: 01234 408479